2014 AAOS Roundup

Adapted from the Spring 2014 issue of Discovery to Recovery

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HSS had a strong presence at the annual meeting of the American Academy of Orthopaedic Surgeons in New Orleans in March. More than 100 HSS physicians and health professionals attended, presenting compelling findings from more than 50 accepted studies. In addition to sharing their research on a wide range of topics, HSS physicians taught courses, moderated numerous panel discussions, and shared their insights at symposiums.

“The annual AAOS event is the world’s largest meeting of orthopedic surgeons and allied health professionals,” said Thomas P. Sculco, MD, HSS physician-in-chief. “The strong participation and enthusiasm of our physicians and scientists at this prestigious event underscores our role as a leader in evidence-based research, best practices and patient-centered care.”

Weight and Joint Replacement

A study by Geoffrey Westrich, MD, director of research, Adult Reconstruction and Joint Replacement at HSS, focused on how weight change after knee or hip replacement affects outcomes. Dr. Westrich and colleagues found that people who manage to lose excess weight do better in terms of function and activity level two years after surgery.

Investigators reviewed the records of almost 7,000 patients enrolled in the HSS Joint Replacement Registry. While many overweight patients have the best intentions to lose weight after knee or hip replacement and some do achieve this goal, the study found that equal numbers of patients actually gain weight. However, the majority of patients maintained the same body mass index (BMI) two years after surgery.

“Our findings represent the largest study to date and the first report to present evidence that weight loss is associated with improved clinical outcomes in terms of function and activity level, while weight gain is associated with inferior outcomes,” says Dr. Westrich. “As physicians, we should convey to our patients the importance of maintaining good health and an appropriate weight, and help them to achieve this goal.”

Joseph Schreiber, MD, and senior author Scott Wolfe, MD, director of the Center, reported that EMG determination of donor nerve quality can improve the outcome of nerve transfer surgery for patients with a brachial plexus injury. The brachial plexus is a network of nerves that extends from the spinal cord, under the collarbone and down the arm, and is responsible for controlling motion and sensation of the entire upper limb. Nerve transfers are performed to connect functioning portions of “donor” nerves to nerves that are so severely damaged that they cannot recover on their own.

“Our study found that pre-operative electromyography should be considered a critical component of the donor nerve selection process when planning brachial plexus nerve transfers,” Dr. Wolfe says. “Traditional clinical measures of muscle strength are inadequate to predict which nerves will be sufficiently active to regenerate functional muscle activity.”